Subthalamic nucleus-deep brain stimulation improves autonomic dysfunctions in Parkinson's disease

Feng Zhang; Feng Wang; Cong-Hui Li; Ji-Wei Wang; Chun-Lei Han; Shi-Ying Fan; Dong-Mei Gao; Yu-Jing Xing; Chen Yang; Jian-Guo Zhang; Fan-Gang Meng

doi:10.1186/s12883-022-02651-z

Subthalamic nucleus-deep brain stimulation improves autonomic dysfunctions in Parkinson's disease

BMC Neurol. 2022 Mar 31;22(1):124. doi: 10.1186/s12883-022-02651-z.

Authors

Feng Zhang¹, Feng Wang^{2

3}, Cong-Hui Li¹, Ji-Wei Wang¹, Chun-Lei Han⁴, Shi-Ying Fan⁴, Dong-Mei Gao⁴, Yu-Jing Xing¹, Chen Yang¹, Jian-Guo Zhang⁴, Fan-Gang Meng^{5

6

7

8}

Affiliations

¹ Department of Neurosurgery, the First Hospital of Hebei Medical University, Shijiazhuang, 050031, Hebei, China.
² Departments of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang, China.
³ Departments of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
⁴ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
⁵ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China. fgmeng@ccmu.edu.cn.
⁶ Beijing Neurosurgical Institute, Capital Medical University, Beijing, 100070, China. fgmeng@ccmu.edu.cn.
⁷ Beijing Key Laboratory of Neurostimulation, Beijing, 100070, China. fgmeng@ccmu.edu.cn.
⁸ Chinese Institute for Brain Research, Beijing, 102206, China. fgmeng@ccmu.edu.cn.

Abstract

Background: To study the effects of subthalamic nucleus-deep brain stimulation (STN-DBS) on autonomic dysfunctions in Parkinson's disease (PD) patients.

Methods: A total of 57 PD patients who underwent bilateral STN-DBS from March to December 2018, were retrospectively analyzed. Preplanned assessments at baseline and postoperatively at 1, 3, and 6 months also included the Scales for Outcomes in Parkinson's Disease-Autonomic questionnaire (SCOPA-Aut), the Unified Parkinson's Disease Rating Scale (UPDRS) III score, levodopa equivalent day dose (LEDD), Parkinson's Disease Quality of Life Scale (PDQ-39), the Hamilton Anxiety Rating Scale (HAMA), and the Hamilton Depression Rating Scale (HAMD).

Results: The SCOPA-Aut scores improved significantly [14.59% (18.32%), 24.00% (27.05%), 22.16% (27.07%), all P < 0.001] at 1 month, 3 months, and 6 months of STN-DBS, respectively. Analysis of the SCOPA-Aut sub-items showed significant improvements only in urine and thermoregulation sub-items at 6 months after surgery (P < 0.001). There was no significant correlation between improvements of SCOPA-Aut scores and improvements of PDQ-39 scores (P > 0.05) at 6 months after surgery. SCOPA-Aut scores were positively correlated with age (r = 0.428, P = 0.001); the improvements of SCCOPA-Aut scores were positively correlated with improvements of HAMA and HAMD scores (HAMA: r = 0.325, P = 0.015; HAMD: r = 0.265, P = 0.049) at 6 months after surgery.

Conclusion: STN-DBS improved autonomic dysfunction symptoms of PD patients, and urinary and thermoregulatory sub-items of autonomic dysfunction were improved in the short-term after surgery. There was a close relationship between improved autonomic symptoms and improved anxiety and depression 6 months after surgery. We should therefore direct more attention to autonomic dysfunctions in PD involving detailed preoperative evaluations and postoperative follow-ups, to improve the quality of life of patients.

Keywords: Autonomic dysfunction; Deep brain stimulation; Non-motor symptoms; Parkinson’s disease; Subthalamic nucleus.

MeSH terms

Deep Brain Stimulation*
Humans
Parkinson Disease* / complications
Parkinson Disease* / diagnosis
Parkinson Disease* / therapy
Primary Dysautonomias*
Quality of Life
Retrospective Studies
Subthalamic Nucleus* / physiology
Subthalamic Nucleus* / surgery